| Doctor Name: | DR. RUSSELL CLIFFORD GAEDE |
| NPI Number: | 1225197759 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PSY.D., LPC |
| License Number: | 268792-6004 |
| Business Practice Address: | 1835 N 1120 W Provo, UT - 846041180 |
| Business Phone Number: | 8016234770 |
| Business Fax Number: | 8016234771 |
| Mailing Address: | Po Box 1001, SPANISH FORK |
| State: | UT |
| Postal Code: | 846607001 |
| Phone Number: | 8016234770 |
| Fax Number: | 8016234771 |
| NPI Enumeration Date: | 12/08/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101Y00000X |
| License Number: | 268792-6004 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | UT |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |